COVID-19 severity and mortality in patients with CLL : an update of the international ERIC and Campus CLL study

Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to Coronavirus disease 2019 (COVID-19) due to age,disease, and treatment-related immunosuppression. We aimed to assess risk factors of outcome and elucidate the impact of CLL-directed treatments on the course of COVID-19. We conducted a retrospective, international study, collectively including 941patients with CLL and confirmed COVID-19. Data from the beginning of the pandemic until March 16, 2021, were collected from 91centers. The risk factors of case fatality rate (CFR), disease severity, and overall survival (OS) were investigated. OS analysis wasrestricted to patients with severe COVID-19 (definition: hospitalization with need of oxygen or admission into an intensive careunit). CFR in patients with severe COVID-19 was 38.4%. OS was inferior for patients in all treatment categories compared tountreated (p < 0.001). Untreated patients had a lower risk of death (HR = 0.54, 95% CI:0.41–0.72). The risk of death was higher forolder patients and those suffering from cardiac failure (HR = 1.03, 95% CI:1.02–1.04; HR = 1.79, 95% CI:1.04–3.07, respectively). Age,CLL-directed treatment, and cardiac failure were significant risk factors of OS. Untreated patients had a better chance of survivalthan those on treatment or recently treated.